Ask Dr. Rachna Pande

Dear Doctor, What are the most common health risks old age (60+) comes with and what is the best way to steer clear of them? Enock Dear Enock, There are multiple health risks which occur with old age. A special branch of geriatric science is designed to describe and discuss such problems. Visible signs of aging are graying of hair and wrinkling of the face, among others. But apart from that every part of the body undergoes degenerative changes. Cataracts in eyes, which impair vision, is one of them. Visual problems are further aggravated by weakness of eye muscles. Reduced hearing is yet another problem due to aging. Due to joints stiffness setting in, one suffers from multiple joint pains. This is common in shoulders, hips, knees, backbone, which are the weight bearing joints of the body. Weakening of bones adds on to the pain. Enlarged prostate in men, prolapsed uterine in women are gender specific problems of aging. Apart from these, there is reduced appetite and digestion. Bowels tend to become sluggish. Sleep is also reduced. Reflexes are reduced, balancing system of body is weakened thus reducing sharpness and alertness, while walking. Lack of productive work can make an old person feel depressed and lack of companionship leads to loneliness. At what age one would start getting these problems and how severe depends on one’s life style factors over years and hereditary factors as well. Prevention of multiple health related problems in old age lies in following healthy habits in young age. Taking a balanced diet from an early age keeps bones, tissues and muscles healthy and strong till later in life. This should include plenty of fresh green vegetables, fruits, whole grains, nuts, fish and healthy milk products. Regular physical exercise keeps joints supple and reduces severity of arthritis. Correct working postures are also helpful in this regard. Alcohol, tobacco and other addicting substances are harmful in multiple ways and best avoided. It is also important to for an individual to continue doing something creative, whatever possible as per their skills and circumstances. This keeps them mentally happy. Family and friends ought to see he does not feel lonely. Thus a person can keep healthy at 60+ age also. ****** Dear Doctor, I am from a very strict religious family, but I am a bit uncomfortable with some of the practices we engage in especially those that I think can pose health complications like compulsory fasting. So I have been wondering what the ideal age is for children to engage in fasting. Aminah Dear Aminah, It is indeed a very sensitive question. The brain needs glucose for healthy functioning, which is provided by food. If fasting is prolonged, one can develop memory disturbances or altered consciousness, so fat is mobilised from the body to provide energy, proteins start getting converted into calories. Thus one can have wasting of muscles causing weakness. Not drinking water for long hours can lead to dehydration. Electrolyte imbalance induced by not eating or drinking can cause disturbances of heart rhythm or muscular weakness. Thus fasting can have serious consequences for the body. This is more so in case of children, whose bodies are growing and are still not so strong. Therefore, the ideal time to start fasting is around adolescence. Precise time should be judged by the child’s physical stamina, his eating habits, his daily time table regarding studies and physical work. Initially the fasting can be restricted to few hours, say skipping just one meal. Water and drinks should be allowed initially. Gradually as he gets accustomed to it, the duration of fasting can be extended. He may be given some incentive like a favourite food or gift if he maintains the stipulated time of fasting, i.e. going without food. Initially the fasting can be for two to three days to judge how well a child is coping. Gradually the period can be extended. ****** Dear Doctor, For the past six months, my one-year old daughter has been experiencing breathing difficulty in the nights yet she behaves very normally during the day. But when I examined her closely recently, I discovered she had some rare growth inside her nasal canal, which I believe is causing this problem. How can she be helped to breathe normally? Christine Dear Christine, Your daughter may have allergic rhinitis, where one experiences a running of nose and sneezing, among others, as symptoms due to exposure to potential allergy causing substances. Secretions from nose may get dried up and block the nose or simply the volume of secretions may block the nose at night, causing breathing difficulty. Common allergens (allergy producing substances) present in the environment are smoke, dust, droppings of insects and mites. It can be due to some bodycare products used or some foods consumed. Allergy tends to run in families. Recurrent cold can also be due to deviated nasal septum (partition between nostrils) causing difficulty in breathing. Chronic recurrent cold can lead to formation of polyps inside nose, which obstructs normal breathing. Attacks of asthma tend to occur more after midnight, causing breathing difficulty. Here there is closure of air tubes which is precipitated due to allergy. Hereditary factors underlie this condition as well. Anti allergy drugs, drugs to open blocked tubes are helpful in providing relief in these conditions. Drinking adequate amount of water, steam inhalation, are also useful. Nasal polyps are treated by surgical intervention. Infection and inflammation of the epiglottis (part behind tongue which separates wind pipe from food pipe) causes throat pain and breathing difficulty. Infections of the lungs also cause breathing difficulty. These infections can be bacterial, viral or fungal. They can be easily diagnosed by physical examination and relevant tests like a full blood count and blood culture. Cure occurs with suitable antibiotic and anti inflammatory drugs. Rarely cancers of the nose or nasopharynx can cause breathing difficulty. These cancers are also cured by surgical intervention. ****** Dear Doctor, We try to keep our house clean but for some reason the houseflies around the premises don’t seem reduce in number. Where could they be coming from and what health dangers do they pose? Kalisa Dear Kalisa, Keeping the house clean is a good measure but it is also important to keep the surroundings clean as well to avoid breeding and multiplication of houseflies. Houseflies live on and multiply in garbage, filth, fecal matter and all kinds of organic trash. They tend to carry germs on their hairy legs and carry them from one place to another. Flies tend to liquefy solid food while vomiting on it and then suck it. Their vomit is also a rich source of germs. They tend to spread diarrhea and other intestinal infections like cholera and typhoid, some of which can be deadly. They also cause and spread eye infections like conjunctivitis. The best prevention measure of houseflies lies in keeping the household and surroundings free of any garbage or filth. All food should be covered properly. Fecal matter of any one suffering from typhoid, any diarrhoeal disease should be disposed of properly. If it is on open ground or beddings, it should be covered with bleaching powder or some disinfectant and then disposed of. Flies can be destroyed by pesticides. Fly traps and fly papers are also available. Keeping a burning candle also keeps flies away.

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Ask Dr. Rachna Pande